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Diffusion-Weighted MR Microimaging of the Lacrimal Glands in Patients with Sjögren's Syndrome

Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan.

View larger version (107K): [in a new window]   Fig. 1A. —23-year-old woman with healthy lacrimal glands. Axial T1-weighted MR image (TR/TE, 400/10; number of signal acquisitions, 3) shows homogeneously intermediate intensity of orbital part of lacrimal gland.

View larger version (134K): [in a new window]   Fig. 1B. —23-year-old woman with healthy lacrimal glands. Axial T2-weighted MR image (2,000/80; number of signal acquisitions, 3) shows homogeneously intermediate intensity of orbital part of lacrimal gland.

View larger version (155K): [in a new window]   Fig. 1C. —23-year-old woman with healthy lacrimal glands. Coronal T1-weighted MR image (400/10; number of signal acquisitions, 3) shows palpebral (P) and orbital (O) parts of lacrimal gland. Arrowheads indicate tendon of superior levator palpebrae muscle separating palpebral and orbital parts of gland.

View larger version (147K): [in a new window]   Fig. 1D. —23-year-old woman with healthy lacrimal glands. Coronal T2-weighted MR image (2,000/80; number of signal acquisitions, 3) shows lacrimal gland with homogeneously intermediate signal intensity. Note tendon of superior levator palpebrae muscle (arrowheads).

View larger version (169K): [in a new window]   Fig. 1E. —23-year-old woman with healthy lacrimal glands. Coronal T1-weighted MR image (400/10; number of signal acquisitions, 3) shows spatial relationship between orbital part of lacrimal gland (O) and lateral rectus muscle (arrowheads).

View larger version (160K): [in a new window]   Fig. 1F. —23-year-old woman with healthy lacrimal glands. Coronal T2-weighted MR image (2,000/80; number of signal acquisitions, 3) shows special relationship between orbital part of lacrimal gland (O) and lateral rectus muscle (arrowheads).

View larger version (103K): [in a new window]   Fig. 2A. —23-year-old woman with healthy lacrimal glands. Coronal diffusion-weighted MR image (TR/TE, 2,292/121; number of signal acquisitions, 6) shows lacrimal gland (dashed line) at b factor of 0 sec/mm2.

View larger version (120K): [in a new window]   Fig. 2B. —23-year-old woman with healthy lacrimal glands. Coronal diffusion-weighted MR image shows lacrimal gland with defined gland contour (dashed line) at b factor of 500 sec/mm2. Region of interest (solid line) was placed on gland for measurement of apparent diffusion coefficient (ADC).

View larger version (102K): [in a new window]   Fig. 2C. —23-year-old woman with healthy lacrimal glands. Coronal diffusion-weighted MR image shows lacrimal gland (dashed line) at b factor of 1,000 sec/mm2. Note gland signals sufficient for ADC determination. Solid line in gland indicates region of interest for ADC measurement.

View larger version (12K): [in a new window]   Fig. 2D. —23-year-old woman with healthy lacrimal glands. Graph shows signal attenuation levels for lacrimal glands versus varying b factors (0, 500, or 1,000 sec/mm2).

View larger version (13K): [in a new window]   Fig. 3. —Box plots show apparent diffusion coefficient (ADC) levels of lacrimal (LG) and parotid (PG) glands from healthy volunteers. Horizontal line is median (50th percentile) of measured values; top and bottom of boxes represent 25th and 75th percentiles, respectively; and whiskers indicate range from largest to smallest observed data points within 1.5-interquartile range presented by box (p < 0.0001, Mann-Whitney U test).

View larger version (11K): [in a new window]   Fig. 4. —Box plot shows apparent diffusion coefficient (ADC) levels of lacrimal glands from healthy men and women. Horizontal line is median (50th percentile) of measured values; top and bottom of boxes represent 25th and 75th percentiles, respectively; and whiskers indicate range from largest to smallest observed data points within 1.5-interquartile range presented by box (p = 0.4856, Mann-Whitney U test).

View larger version (11K): [in a new window]   Fig. 5. —Graph shows age-related changes in apparent diffusion coefficient (ADC) levels from healthy volunteers. Regression line is shown.

View larger version (114K): [in a new window]   Fig. 6A. —64-year-old woman with Sjögren's syndrome. Coronal T1-weighted MR image (400/10; number of signal acquisitions, 3) shows lacrimal gland with heterogeneous signal intensity (arrowheads).

View larger version (110K): [in a new window]   Fig. 6B. —64-year-old woman with Sjögren's syndrome. Coronal fat-suppressed spectral presaturation with inversion recovery (SPIR) T2-weighted MR image (2,166/80; number of signal acquisitions, 3) shows lacrimal gland with heterogeneous signal intensity. Note that high intensities on T1-weighted image (A) are suppressed on SPIR image.

View larger version (13K): [in a new window]   Fig. 7. —Box plots show apparent diffusion coefficient (ADC) levels of lacrimal glands from healthy volunteers (Controls) and patients with Sjögren's syndrome (SS) (p < 0.0001, Mann-Whitney U test). c = outlier.

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